title: Racial and ethnic disparities in ADHD diagnosis from kindergarten to eighth grade.
abstract: OBJECTIVE
  Whether and to what extent racial/ethnic disparities inattention-deficit/hyperactivity disorder (ADHD) diagnosis occur across early and middle childhood is currently unknown. We examined the over-time dynamics of race/ethnic disparities in diagnosis from kindergarten to eighth grade and disparities in treatment in fifth and eighth grade.
  
  
  METHODS
  Analyses of the nationally representative Early Childhood Longitudinal Study, Kindergarten Class of 1998–1999 (N = 17 100)using discrete-time hazard modeling.
  
  
  RESULTS
  Minority children were less likely than white children to receive an ADHD diagnosis. With time-invariant and -varying confounding factors statistically controlled the odds of ADHD diagnosis for African Americans, Hispanics, and children of other races/ethnicities were 69% (95% confidence interval [CI]: 60%–76%), 50% (95% CI: 34%–62%), and 46% (95% CI: 26%–61%) lower, respectively, than for whites. Factors increasing children’s risk of an ADHD diagnosis included being a boy,being raised by an older mother, being raised in an English-speaking household, and engaging in externalizing problem behaviors. Factors decreasing children’s risk of an ADHD diagnosis included engaging in learning-related behaviors (eg, being attentive), displaying greater academic achievement, and not having health insurance. Among children diagnosed with ADHD, racial/ethnic minorities were less likely than whites to be taking prescription medication for the disorder.
  
  
  CONCLUSIONS
  Racial/ethnic disparities in ADHD diagnosis occur by kindergarten and continue until at least the end of eighth grade. Measured confounding factors do not explain racial/ethnic disparities in ADHD diagnosis and treatment. Culturally sensitive monitoring should be intensified to ensure that all children are appropriately screened, diagnosed,and treated for ADHD.
authors.affiliation: Department of Educational Psychology, Counseling, and Special Education, Pennsylvania State University, University Park, PA, USA. paul.l.morgan@gmail.com
authors.forename: Paul L
authors.initials: PL
authors.lastname: Morgan
authors.forename: Jeremy
authors.initials: J
authors.lastname: Staff
authors.forename: Marianne M
authors.initials: MM
authors.lastname: Hillemeier
authors.forename: George
authors.initials: G
authors.lastname: Farkas
authors.forename: Steven
authors.initials: S
authors.lastname: Maczuga
mesh_terms: D000293:Adolescent; D001741:Black or African American / Q000706:statistics & numerical data*; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis* / Q000208:ethnology* / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D054624:Health Status Disparities; D054625:Healthcare Disparities / Q000208:ethnology*; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D007389:Internal-External Control; D008137:Longitudinal Studies; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data; D016017:Odds Ratio; D012306:Risk; D012737:Sex Factors; D014481:United States; D044465:White People / Q000706:statistics & numerical data*